- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,241.22 / $10,431.19 / $21,899.37
| Facility | | $4,241.22 | $10,431.19 | $21,899.37 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,195.75 / $12,094.93 / $23,395.49
| Facility | | $9,195.75 | $12,094.93 | $23,395.49 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,370.69 / $2,398.71 / $9,496.00
| Facility | | $1,370.69 | $2,398.71 | $9,496.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,739.86 / $3,404.88 / $4,803.29
| Facility | | $2,739.86 | $3,404.88 | $4,803.29 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,777.00 / $8,220.00 / $9,696.00
| Facility | | $6,777.00 | $8,220.00 | $9,696.00 |